System and methods for qualification of ecg data for remote analysis

ABSTRACT

A method of obtaining and analyzing ECG data from a patient or group of patients is disclosed. The ECG data is obtained from the patient at an acquisition device. Once the ECG data is obtained, the ECG data is transmitted to an analysis server that is operated by an analysis provider and is located remote from the location of the acquisition device. Along with the ECG data, acquisition parameters are transmitted to the analysis server. At the analysis server, one of a plurality of algorithms is selected to analyze the ECG data. If an abnormality is detected, the patient information is directed to a healthcare provider who can then contact the patient to schedule an appointment. Based upon the referral, a referral fee can be transferred from the healthcare provider to the analysis provider. The patient can be prompted to provide additional information and selections that dictate the level of analysis generated.

BACKGROUND

The present disclosure relates to a method and system for analyzing ECGdata from patients. More specifically, the present disclosure relates toa system and method that receives ECG information from patients andprovides analysis techniques that utilize remote analysis and datareporting.

Cloud-based technology is modifying and changing the ways that softwareservices are being sold and utilized. Currently, instead of owning acopy of a software product, cloud-based computing allows users to accesssoftware programs utilizing cloud-base technology and pay only for whatthe user utilizes. Cloud-based computing allows large applications thatconsume significant amounts of storage space to be stored at remotelocations and be accessed by a user utilizing an online browser.Cloud-based computing creates many advantages for the user and enablesdifferent types of business models.

Presently, many different companies and manufacturers sellelectrocardiographs that include both the physical hardware to capturean ECG from a patient and the software algorithms required to identifyarrhythmias and other irregularities in the ECG data. Suchelectrocardiographs must have the required processing power and storagespace to analyze the ECG data and provide diagnostic information to aclinician or user. The electrocardiographs are typically updated whennew processing algorithms are developed, which may require additionalstorage space on the electrocardiograph machine.

SUMMARY

The systems, devices and methods described herein relate to processingand analyzing of medical data, and in particular, analyzing andprocessing ECG data obtained from patients. In accordance with oneembodiment of the disclosure, ECG data is obtained from one or morepatients at an acquisition device that is located at a first location.The acquisition device can be one of a wide variety of different typesof hardware equipment, including exercise machines, automobile steeringwheels, personal health tracking wearable devices, watches, smartphones,dedicated kiosks or any other type of device that is able to obtain ECGdata from a patient and digitize the ECG data.

Once the ECG data is obtained from the patient, the ECG data istransmitted to an analysis server that is operated by an analysisprovider and is positioned at a second location that is remote from theacquisition device. The analysis server includes a plurality ofalgorithms, each of which is operable to detect abnormalities in the ECGdata.

In addition to transmitting ECG data to the analysis server, the methodalso transmits acquisition parameters that are related to the specificacquisition device and conditions present when the ECG data is obtainedfrom the patient. The acquisition parameters can include the specificparameters related to the acquisition device or could be identificationinformation that is used by the analysis server to lookup specificparameters related to the acquisition device. In each case, the analysisserver is able to determine acquisition parameters that can be used toselect the specific algorithm used to process the ECG data.

Once the ECG data and acquisition parameters are obtained, the selectedalgorithm operating on the analysis server detects abnormalities presentin the ECG data. If no abnormalities are detected, the patient isinformed of the “normal” ECG data. However, if abnormalities aredetected, the patient is referred to a healthcare provider, which may bea medical clinic, healthcare facility, or physician. Specifically,patient information, the analysis results from the analysis server andthe ECG data are sent to a subscribing healthcare provider. Upon receiptof this information, the healthcare provider contacts the patient toschedule an appointment with the healthcare provider. The scheduling ofthe additional appointment is thus driven by the analysis of the ECGdata and the detected abnormalities. In this manner, the healthcareprovider contacts patients that are in need of further attention, whichwill lead to a high rate of billable appointments. Since the referralincreases the revenue generated by the healthcare provider, a referralfee is directed from the healthcare provider to the analysis providerthat operates the analysis server.

In another embodiment of the present disclosure, a microsite can becreated within a healthcare provider's health website to provide aportal for access by a patient. The microsite portal allows the patientto upload ECG data to the health website. Once the ECG data is obtainedby the health website, the ECG data is transmitted to the analysisserver for processing. If abnormalities are detected, the healthcareprovider that operates the health website contacts the patient toschedule additional appointments. Once again, the additionalappointments based on the analysis of the ECG data generate additionalrevenue for the healthcare provider a referral fee can be transmittedfrom the healthcare provider to the analysis provider to compensate forthe additional revenue created by the analysis server.

In yet another embodiment of the present disclosure, the analysisprovider and an interested entity, such as a healthcare provider,government agency or insurer can work together to identify a segment ofa patient population having an overall cardiac health that could beimproved or having a cost of future treatment that could be reduced byutilizing early ECG analysis. Once the patient population is identified,the patients in the patient population are contacted and urged to obtainan ECG reading. The ECG reading can be carried out by one of theacquisition devices and the obtained ECG data transmitted to theanalysis server. If abnormalities are detected, the patient is contactedby the healthcare provider to schedule additional appointments. Theearly detection of healthcare related issues through the increase in thenumber of ECG measurements has a cost benefit that can be calculated bythe analysis provider. Since healthcare costs are reduced, the analysisprovider obtains payment based upon the amount of healthcare savings.

Various other features, objects and advantages of the invention will bemade apparent from the following description taken together with thedrawings.

BRIEF DESCRIPTION OF THE DRAWINGS

The drawings illustrate the best mode presently contemplated of carryingout the disclosure. In the drawings:

FIG. 1 is a schematic illustration showing the communication betweenvarious acquisition devices and remote servers, healthcare providers andinsurers utilizing cloud-based communication;

FIG. 2 is a flow chart illustrating one method in accordance with anembodiment of the present disclosure;

FIG. 3 is a flow chart illustrating a second method in accordance withanother embodiment of the present disclosure;

FIG. 4 is a flow chart illustrating a third method in accordance withanother embodiment of the present disclosure; and

FIG. 5 is a flow chart illustrating a fourth method in accordance withanother embodiment of the present disclosure.

DETAILED DESCRIPTION

FIG. 1 illustrates a general communication system 8 that enables themethods and systems of the present disclosure. In the embodiment shownin FIG. 1, a plurality of different types of ECG acquisition devices 10are shown communicating information to remote locations through theinternet, which is referred to as the “cloud” in FIG. 1 and throughoutthe present disclosure. The ECG acquisition devices 10 each function toobtain ECG data from one or more patients 14. Although the embodimentshown in FIG. 1 is described as obtaining ECG data from the patients 14utilizing the ECG acquisition devices 10, it should be understood thatthe acquisition devices 10 could obtain other types of medical data fromthe patient, such as blood pressure, weight, heart rate, temperature, orany other type of medical data that may be useful in analyzing thecurrent health status of the patient 14.

In the embodiment shown in FIG. 1, the ECG acquisition device can be oneof a large variety of hardware devices that are able to record ECGinformation from a patient. These devices could be traditional ECGrecording devices, ambulatory ECG recording devices such as a Holtermonitor or an event recorder. Further, current hardware devices existthat incorporate ECG sensing electrodes into other types of devices suchas exercise machines, automobile steering wheels, watches, smartphonesor any other contemplated type of location or device where theinteraction between the patient 14 and the acquisition device may besufficient to obtain ECG information from the patient.

In other embodiments, the acquisition devices could be stand alone ECGacquisition devices that are located in public areas, such as shoppingmalls, office buildings, health clinics, or any other place where apatient could interact with the acquisition device 10 to obtain ECGinformation from the patient. As an example, a kiosk could be createdthat includes two metal disks on the kiosk which instructs the patientto touch the metal disks to obtain the ECG information. The kiosk-basedacquisition device would contain the necessary hardware to digitize theECG information obtained from the user and either provide a digital copyto the patient or transmit the obtained ECG data through the cloud 12.The communication between the acquisition device 10 and the cloud couldbe through a Wi-Fi network, direction connection to the internet, amobile data network, a cellular network, direct connection to phonelines or any other type of communication that would allow thecommunication line 16 between the acquisition device 10 and the cloud 12to exist.

In addition to obtaining the ECG information at the acquisition device10, it is contemplated that he acquisition device 10 may allow thepatient to input data regarding their healthcare provider, insuranceprovider, and their condition or status at the time the ECG is taken.This additional information would be associated with the ECG data andtransmitted over the cloud 12. As an example, the patient can inputsymptoms felt before and/or during the ECG recording and can inputactivities the user was engaged in prior to and/or during the ECGrecording process.

Since the ECG acquisition devices 10 are contemplated as taking multipledifferent forms and/or configurations, it is important for the methodand system of the present disclosure to communicate various acquisitionparameters that are associated with the acquisition device 10 andcommunicate this information with the patient specific ECG data beingtransmitted over the cloud 12. One method of associating the requiredacquisition parameters with the ECG data would be to pre-register eachof the data acquisition devices 10 such that the acquisition device 10would be associated with ECG data when the data is transmitted over thecloud. Such a registration service would allow for identification dataof the acquisition device 10 to be transmitted with the ECG data fromthe patient such that during subsequent review and analysis at theserver 18, the acquisition device parameters would be known to theanalysis server 18.

In accordance with a second alternate embodiment, the relevantacquisition parameters that are associated with the acquisition device10 could be transmitted along with the ECG data. Thus, instead ofrequiring the acquisition device 10 to be pre-registered, the ECG datatransmitted would include the specific acquisition parameters such thatthe acquisition parameters would be incorporated and utilized during theanalysis of the patient ECG data. It is contemplated that this second,alternate embodiment would require additional data to be transmittedwith each set of ECG data. However, the method would eliminate the needfor pre-registration of each of the acquisition devices, which mayprovide additional benefits.

Since a large variety of currently available and yet to be developedacquisition devices 10 are contemplated, it is important that theacquisition parameters be known during the analysis of the ECG data. Asan example, ECG data that is received from the patient can be used fordifferent clinical purposes, such as rhythm interpretation,interpretation of conduction and ischemic conditions, and interpretationof contour based features. Depending upon the clinical use of the ECGdata, specific aspects and parameters of the acquisition device 10 andthe resulting ECG data from the patient are relevant. Such acquisitionparameters can include sample rate, frequency response, number andplacement of the ECG leads, pacemaker detection, and data resolution. Byeither pre-registering the acquisition device 10 or by sending theacquisition parameters along with ECG data, the analysis of the ECG datafrom the patient can be properly analyzed.

In the embodiment shown in FIG. 1, the ECG data obtained from each ofthe patients 14 by the acquisition device 10 is transmitted along thecommunication line 16 to the cloud 12. A remote analysis server 18 isshown in FIG. 1 as also communicating to the cloud 12 over communicationline 20. The remote analysis server 18 is contemplated as being operatedand provided by an analysis provider that either houses or maintains theserver 18. The analysis provider can be any type of entity that is ableto provide a remote server 18 that receives ECG data and analyzes theECG data for irregularities in the ECG data, which can include a varietyof different diagnoses, including arrhythmia. The remote analysis server18 will include a number of algorithms that are able to analyze the ECGdata obtained from the patient and provide automated analysis. Thesealgorithms are known and used in many stand alone electrocardiographmachines and systems, such as provided by GE Healthcare and others. Inthe embodiment shown in FIG. 1, a human expert 22 can communicate withthe remote analysis server 18 to provide human over-reading of the ECGdata if necessary, as will be discussed in greater detail below. Thehuman expert 22 could comminute directly with the server 18 or couldcommunicate to the server 18 over the cloud 12.

It is contemplated that the remote analysis server would be operated andcontrolled by an analysis provider, which could include currentcompanies that manufacture and provide electrocardiograph hardware.However, it is also contemplated that the analysis provider thatoperates and controls the remote analysis server 18 could be any othertype of company or entity that develops analysis algorithms and providesthe required hardware to function as the remote analysis server. It iscontemplated that the remote analysis server would include the requiredcomputing processor or processors to receive ECG data from a largenumber of patients and analyze the data in a timely manner to returnanalysis information in a time frame as desired.

In currently available systems in which the electrocardiograph receivesinformation directly from the patient and the algorithms are carried outwithin the electrocardiograph, the data acquisition parameters are not aproblem since they are known to the algorithm operating on theelectrocardiograph. However, in the embodiment shown in FIG. 1 in whichthe remote analysis server is located remote from the variousacquisition devices 10, the source and acquisition parameters associatedwith the ECG is important. Thus, there must be system and method inplace such that the ECG data can be qualified in terms of theacquisition parameters so that the analysis algorithms operating on theremote analysis server 18 and the results generated can be returned thatare clinically appropriate for both their intended use and based uponthe data acquisition parameters. As an example, if one of theacquisition devices includes electrodes that provide 12-lead ECG data,the remote analysis server 18 must be able to identify this type of dataand utilize an algorithm that is intended for the analysis of 12-leadECG. Likewise, if the data is not acquired from standard lead positionsor if the data acquisition device is of such configuration that it haslower bandwidth, the interpretation carried out by the remote analysisserver 18 must utilize an appropriate algorithm. As indicated above, thedata acquisition device 10 can either be pre-registered or cancommunicate acquisition parameters along with the patient ECG data. Thedata acquisition parameters are typically published or available foreach of the data acquisition devices 10 and can thus be accessed by theremote analysis server 18 prior to selecting the appropriate analysisalgorithm.

In accordance with the embodiment shown in FIG. 1, the remote analysisserver 18 will receive ECG data from one of the acquisition devices 10along with either device identification information or informationrelated to the acquisition parameters. If the information includes theidentification of the acquisition device, the remote analysis server 18will utilize some type of look up table to obtain the acquisitionparameters related to the acquisition device. Such look up table wouldinclude published information related to the acquisition device, whichis typically available from the device manufacturer. Once theacquisition parameters are obtained, the remote analysis server 18 canselect and run the required algorithm based upon the acquisitionparameters.

In accordance with another embodiment in which the acquisitionparameters are transmitted along with the ECG data, the remote analysisserver 18 would interpret the acquisition parameters and select andutilize the required analysis algorithm based upon the acquisitionparameters. In each case, the remote analysis server 18 utilizesdifferent algorithms based upon the acquisition parameters obtained fromthe acquisition device 10. In this manner, the remote analysis server 18can tailor the analysis and selected algorithm based upon the type ofacquisition device 10 utilized to obtain the ECG data from the patient14. Such identification allows for a wide variety of differentacquisition devices 10 to be utilized such that the ECG data analysis isable to be performed independent of the type of acquisition device 10.

In the embodiment shown in FIG. 1, the remote analysis server 18 and theacquisition devices 10 each communicate with each other through thecloud 12. In addition, various other entities, such as a healthcareprovider 24, an insurer 26, and a health website 28 also from part ofthe overall system 8. Each of these separate entities can communicatewith the remote analysis server 18 utilizing the cloud 12. The healthwebsite 28 may be one of a wide variety of health-based websites thatallow an individual patient or user 14 to access information. As anexample, the health website 28 could be WebMD, Mayo Clinic, ClevelandClinic, or any other type of large website controlled and operated byhealthcare providers or facilities that provides patients access toinformation.

The system and configuration shown in FIG. 1 allows for a wide varietyof different types of business models to be carried out generally basedupon the remote analysis of ECG data from the large and wide variety ofdifferent types of ECG data acquisition devices 10. A first method madepossible by the system of FIG. 1 is illustrated in FIG. 2. The method ofFIG. 2 will be explained in detail below with reference to the system 8shown in FIG. 1.

In step 30, the ECG acquisition device 10 obtains patient ECG data fromthe patient in the manner described above. As indicated above, theacquisition device 10 used to obtain information from the patient 14 canbe one of a wide variety of hardware devices, such as an exercisemachine, an automobile steering wheel, an electrocardiograph, a kiosk, awatch, a fitness tracker, smart phone or a wide variety of otherhardware devices. This ECG data obtained from the individual patient isdigitized and transmitted to the remote analysis server 18 asillustrated in step 32. The transmission of the digitized ECG data tothe remote analysis server can be carried out over the cloud 12utilizing a wide variety of communication techniques to create thecommunication line 16. As an example, the communication line 16 betweenthe acquisition device 10 and the cloud 12 may be a cell phonecommunicating over either a cellular data network or utilizing Wi-Fi. Inaddition, the ECG acquisition device 10 could communicate directly tothe remote analysis server 18 over to the cloud utilizing communicationcontrolled by the acquisition device 10. In one contemplated embodiment,a kiosk in a mall could include two metal disks that allow the patientto place their hands on the metal disks such that the kiosk would obtainthe required ECG data. Once the data is obtained, the kiosk that formsthe acquisition device 10 would utilize required hardware at the kiosklever to digitize the ECG data and send the digitized ECG data over thecloud 12.

It is contemplated that the ECG data transmitted by the data acquisitiondevice over the cloud may or may not include patient data. If theresults from the remote analysis server 18 are going to be presented tothe patient immediately at the acquisition device, patientidentification information may not needed. Instead, the patient may onlyneed to provide relevant information such as age, height, weight, andother parameters that may be utilized in carrying out the analysisutilizing the algorithms present at the remote analysis servers.However, in embodiments in which the information obtained from thepatient is used in further analysis, patient identification informationwill be obtained. This patient identification information may includeunique identifiers to the patient, such as a social security number,cell phone number, health insurance account number, healthcare providerinformation, or any other information that can be utilized in subsequentprocessing to inform the patient of the analysis results.

Referring back to FIG. 2, once the ECG data and acquisition parameterrelated to the acquisition device 10 are transmitted to the remoteanalysis server 18, the remote analysis server selects the mostappropriate analysis algorithm and utilizes the selected algorithm toanalyze the raw ECG data for abnormalities, as illustrated in step 34.These abnormalities may be any type of abnormality identified in an ECG.In the embodiment illustrated in FIG. 2, these abnormalities are focusedon arrhythmias present in the ECG data.

In step 36, if no abnormalities are detected, such positive analysis istransmitted back to the acquisition device 10 from the remote analysisserver. This information could be presented immediately to the patientas illustrated in step 38. Alternatively, if the processing carried outthe remote analysis server 18 will take more time than is available forthe patient to remain at the acquisition device 10, the patient 14 maybe prompted to provide contact information, such as a cell phone number.If the ECG is determined to be normal in step 36, the patient would benotified as soon as possible that the ECG analysis returned a “normal”analysis result. In the embodiment shown in FIG. 2, it is contemplatedthat the patient would be charged a nominal fee for the analysis of theECG data and the return of the “normal” determination. The analysisresult returned to the patient in step 38, if provided on the cellphone, would utilize the cell phone or smartphone as the graphic userinterface (GUI) to return the analysis results. These results couldinclude analysis information, depictions of ECG graphs, or any otherinformation that could be presented on the GUI of the patient's cellphone.

If abnormalities are detected in the ECG data in step 36, the methodmoves to step 40 in which the patient is informed of the possiblepresence of an arrhythmia or abnormality in the ECG data. The patientcan be notified in the same manner as in step 38, namely either at theacquisition device 10 or through a cell phone or computer addressprovided by the patient during the initial acquisition phase. In step40, the method also obtains healthcare provider information from thepatient. As indicated above, the healthcare provider information couldbe obtained when the patient initially begins the ECG acquisitionprocess. Alternatively, if an abnormality or irregularity is identified,the method could contact the patient utilizing either the email addressor cell phone.

The healthcare provider information obtained from the patient in step 40identifies the current healthcare provider for the patient. This may bea clinic, hospital, healthcare group, or any other type of healthcareprovider information that is available from the patient. The patient maybe also asked to provide insurance information, which would be used toselect a healthcare provider if the patient does not have a currenthealthcare provider and would need assistance in selecting a healthcareprovider.

Once the healthcare information is obtained from the patient in step 40,the method moves to step 42 in which the remote analysis server operatedby the analysis provider makes a direct referral of the patient to ahealthcare provider network, insurer, or a specific physician. Thereferral generated by the analysis provider is based directly upon theidentification of an abnormality in an ECG analyzed by the remoteanalysis server. The referral generated in step 42 would include as muchinformation about the patient as is available, including patientidentification information, the raw ECG data obtained from the patient,and an automated arrhythmia analysis report that is created by theremote analysis server 18. This information would be the informationnecessary for the healthcare provider to obtain initial informationabout the patient and would allow the provider to contact the patientdirectly in step 44 to set up an appointment, which would generateadditional fees for the healthcare provider. The referral from theanalysis provider operating the remote analysis server 18 will generateadditional revenue for the healthcare provider, insurer, or physicianutilizing the referral in step 44.

As can be understood in FIG. 1, the wide variety of differentacquisition devices 10 and non-typical locations for the devices allowfor a greater population of patients 14 to be serviced at thenon-typical locations, such as shopping malls, on exercise equipment orany other location in which ECG data can be obtained from non-typicalsources outside of a typical electro-cardiograph. As an added benefit,many patients will have ECG data recorded when the patient is otherwisehealthy simply based on the ease of access. The additional number ofpatients 14 that will have ECG data analyzed with aid in preventinghigh-risk, high-costs medical events by detecting arrhythmias earlierand before a catastrophic event may occur.

In the method shown in FIG. 2, the last step in the process is for areferral fee to be directed from the healthcare provider to the analysisprovider as shown in step 46. This referral fee is a direct result of apatient having an arrhythmia/abnormality detected in ECG data beingreferred to the healthcare provider, which generates additional revenuefor the healthcare provider. The referral fee can be utilized along withany charge to the patient to fund and operate the remote analysis server18 by the analysis provider. As can be understood by the abovedescription, the use of ECG data obtained from patients at non-typicallocations will aid in early detection of health problems, which willincrease the overall population health and decrease costs associatedwith higher acuity healthcare services.

FIG. 3 illustrates another method that can be carried out utilizing thesystem configuration generally shown in FIG. 1. The method carried outin FIG. 3 is similar to the method of FIG. 2. However, the embodimentshown in FIG. 3 utilized an entry point that is incorporated into thehealth website 28 shown in FIG. 1. Referring now to FIG. 3, in step 60 a“microsite” is developed by the analysis provider and is incorporatedinto the health website 28. The “microsite” incorporated into thewebsite provides an access point for the patient 14 to upload or inputECG data and other patient information. In step 62, the patient isdirected to input ECG information into the microsite. The ECGinformation can be stored data that is obtained from any one of the ECGacquisition devices 10. As discussed previously, the acquisition devicescan be watches, phones, exercise equipment, kiosks or any other type ofacquisition device that is able to obtain ECG data from the patient. TheECG data can be stored at some location directed by the patient or canbe directly into the microsite created on the health website 28. Oncethe patient has the ECG data from one of the acquisition devices, thepatient visits the health website 28 and is prompted to upload ECG datainto the website. The health website is a typical website provided byhealthcare providers, such as Mayo.com, WebMD, or other healthcareproviders that operate health websites 28 for the benefit of their planparticipants or patients.

Once the patient visits the provider website and uploads the ECG data instep 64, the ECG data is transmitted to the remote analysis server asillustrated in step 66. As discussed above in the description of FIG. 2,once the ECG data is transmitted to the remote analysis server, theremote analysis server selects and utilizes one of a series ofalgorithms to analyze the ECG data to determine whether abnormalitiesare present in the ECG data as indicated in steps 68 and 70. If noabnormalities are detected, the patient is advised in the same manner asdiscussed with respect to step 38. However, if abnormalities aredetected, since the patient is already accessing a provider healthwebsite 28, the patient is directed to schedule an appointment with theprovider as indicated in step 74. Unlike the embodiment shown in FIG. 2,information about the patient does not need to be provided to thehealthcare provider since the patient is already accessing the micrositecreated by the analysis provider within the health website 28 operatedby the healthcare provider. It is contemplated that the appointmentscheduled with the provider in step 74 can be accomplished immediatelyonline within the healthcare provider's health website 28. Since themicrosite can be created by the analysis provider, the analysisgenerated by remote analysis server 18 again identifies patients thatmay not have otherwise known there were abnormalities present in ECGinformation. The increase in number of patients will increase therevenue to the healthcare provider and the analysis provider will againreceive a referral fee as indicated in step 76. The method shown in FIG.3 closely corresponds to the method of FIG. 2 but instead utilizes amicrosite created by the analysis provider on the healthcare provider'swebsite 28 to both provide additional features to the clients/patientsof the healthcare provider and also to identify additional patients thatmay need to schedule an appointment with the healthcare provider.

FIG. 4 illustrates yet another method that can be performed and carriedout utilizing the configuration and system 8 shown in FIG. 1. Like theembodiments shown in FIGS. 2 and 3, the method of FIG. 4 obtains ECGdata from the various different types of hardware devices as illustratedin step 90. The ECG data obtained from the patient is transmitted to theremote analysis server 18 as illustrated in step 92. However, in themethod shown in FIG. 4, once the ECG data is uploaded to the remoteanalysis server 18, the patient is prompted to provide additionalinformation and selections as to the type, cost and speed of analysis tobe provided by the remote analysis server. The information obtained fromthe patient in step 94 will be presented to the patient along withinformation as to the price points associated with each of theselections.

In step 96, the remote analysis server 18 initially inquires with thepatient as to the quality level of review that is desired. The qualitylevel review may span from the basic arrhythmia analysis that can beautomatically performed by the algorithms contained on the remoteanalysis server 18 to human over-read analysis to longitudinal analysis.Typically, the human over-read and longitudinal analysis requires asignificant amount of additional attention and thus will not onlyincrease the quality level of the determination but will also increasethe total price point to the patient.

When the remote analysis server initially receives the ECG data from thepatient, an initial algorithm at the remote analysis server with inspectthe ECG data to determine the quality level of the ECG data. Thisquality level will take into account the length of the ECG recording,the amount of noise present in the ECG data, the number of leads used toobtain the data and the type of acquisition device that was used toobtain the data. As discussed previously, the different types ofacquisition devices can vary greatly and thus will determine the type ofanalysis that can be performed by the remote analysis server 18.

If the patient selects a human over-read in step 96, the remote analysisserver 18 then carries out the step of contacting a human clinician toover-read the analysis generated by the algorithms operating on theremote analysis server. The specific nature of the human over-read canalso be selected by the patient. The different types of human over-readinclude an auction approach, standard human over-read, premium over-readby a noted specialist or marquee provided (e.g. Cleveland Clinic). Eachof these different levels of human over-read may have a different pricepoint associated with the analysis. All of these different options arepresented to the patient and the patient is able to select between thedifferent types of human over-read depending upon the type of analysisand cost desired by the patient. FIG. 1 indicates that the human expert22 can access the ECG data from the remote analysis server 18 directlyor possibly through the cloud 12.

Once the patient has provided the quality selection in step 96, themethod moves to step 98 in which the patient is asked to select thedesired response time for the analysis. A response time can vary betweenminutes, hours or days. Typically, the faster the response time, thehigher the price point. As an example, if the user would like a premiumhuman over-read returned in hours, the price point may be dramaticallyhigher than an automated algorithm analysis returned in a matter ofdays. Once again, step 98 allows the patient to select the response timeand pay accordingly.

In step 98, if a user uploads ECGs in bulk the user could specify rulesfor priority such that if a dangerous arrhythmia is detected, animmediate response should be generated and an immediate human over-readshould be ordered. Again, this step allows the patient/user to dictatethe cost of analysis by selecting the quality of the review and theresponse time.

In step 100 the patient is able to specify the type of analysis desired,such as standing resting analysis, holter analysis, stress tests, heartrate recovery. Each type of analysis is presented at varied pricepoints. By allowing the patient to select the type of analysis, thesystem again can offer the patient a variety of options at differentprice points.

The analysis type selected by the patient in step 100 could also becarried out by the remote analysis server 18 upon receiving the uploadedpatient ECG file. The remote analysis server 18 can review the uploadedECG data and automatically suggest the appropriate type of analysisdepending upon the type of acquisition device and other informationrelated and present in the obtained ECG information.

Once the user has made the selections in steps 96, 98 and 100, themethod moves to step 102 and carries out the required analysis basedupon the patient selections. In step 104, the method determines whetherabnormalities are detected and if no abnormalities are detected, thepatient is informed as shown in step 106. However, like the methoddiscussed in FIG. 2, if abnormalities are detected, the patient isinformed in step 108 and the analysis is provided to the healthcareprovider as part of the referral in step 110. The provider then contactsthe patient in step 112 and a referral fee is paid to the analysisprovider in step 114.

Since the method in FIG. 4 requires additional patient input, it iscontemplated that such communication with the patient would occurthrough some type of website or dedicated input terminal. Since there isadditional patient input, it is contemplated that the method of FIG. 4will provide additional functionality such as possibly reminding thepatient to capture additional ECG data in the future. Such reminders canbe in the form of email, automated telephone calls, automated texts orother means. In addition, it is contemplated that the patient can chooseto store a longitudinal patient record in a secure and HIPAA compliantcloud server through feature analysis and/or comparison to subsequentECG data obtained utilizing the acquisition devices. In this manner,additional patient options are presented and the cloud server time isoptimized based upon specific instructions from the patient as to thelevel of service and price points desired.

Referring now to FIG. 5, thereshown is yet another method that can becarried out utilizing the system configuration shown in FIG. 1. In theembodiment shown in FIG. 5, the method provides a comprehensive solutionfor cardiac health, including hardware, cloud services for arrhythmiaanalysis and population metrics. The focus of the method shown in FIG. 5is to improve the overall cardiac health of a population of patients orto reduce the overall cardiology related expenses of a population ofpatients. The method of FIG. 5 utilizes the availability of the ECGacquisition devices 10 and the transmission of ECG data from theindividual patients to a remote analysis server in an attempt to improvethe health of a group of patients and/or to reduce the healthcarerelated expenses of this population of patients.

In the method of FIG. 5, the analysis provider that operates the remoteanalysis server 18 contracts with some other entity, such as ahealthcare provider, government agency, insurer or other entity that hasa goal of cost reduction. After contracting with the external agency,cost reduction targets are calculated based upon projections made usinga cost benefit analysis of both early detection and intervention. As anexample, one target may be to identify numbers of an elderly populationthat have AFIB. By identifying these members of a population andproviding increased monitoring and analysis, intervention or treatmentmay be available to avoid a more costly event, such as a stroke.Performance metrics can be established between the analysis provider andthe entity to share in the potential savings and positive outcomes. Theanalysis provider will receive financial incentives based upon whenoutcomes are met and thus has a direct stake in the improved healthcareof the group of patients.

As illustrated in FIG. 5, the healthcare provider, which may be agovernment agency, insurer or healthcare clinic, meets with the analysisprovider to develop cost reduction targets, as illustrated in step 150.Upon developing the cost reduction targets, the healthcare provider andthe analysis provider identify patients within a particular preventionclass. As indicated above, this prevention class may be elderly patientsthat have a higher risk of AFIB. Once this class of patients has beenidentified, the healthcare provider contacts this group of patients toprompt the group of patients to obtain ECG readings. These ECG readingscan come from any one of the ECG acquisition devices 10 shown in FIG. 1.Since the ECG acquisition devices can be one of the wide variety ofpossible alternatives discussed above, it is much easier for thepatients within the prevention class to obtain ECG data as compared totraveling to a health clinic.

Once the ECG data is obtained from the patients in step 154, the ECGdata is transmitted to the remote analysis server in step 156 andanalyzed in step 158 to determine whether abnormalities, such asarrhythmia are present. The steps are similar to those previouslydiscussed in the method described in FIG. 2. If abnormalities are notdetected in step 160, the patient is informed in step 162. However, ifabnormalities are detected in step 160, the method moves to step 164 andthe patient is informed and the patient is referred to the healthcareprovider. Since the patient is already associated with the healthcareprovided, the healthcare provider can then contact the patient andschedule additional medical testing and procedures as desired.

Since the patient was identified in step 154 and urged to have an ECGreading taken in step 154, if an abnormality is detected in step 160, itis a patient that would not otherwise have been tested but for themethod of FIG. 5. Thus, early detection is a benefit of the method inFIG. 5. In step 166, the analysis provider calculates cost savings basedupon the identification of patients at early stages. The calculated costsavings and metrics identified in step 166 are quantified financiallyand the analysis provider is allocated a percentage of the cost savings.In this manner, the analysis provider is rewarded financially with thecost savings associated with early detection in a patient populationthat may otherwise not have been tested. As a result of the method shownand described in FIG. 5, early detection for the identified populationaids in a healthier population and reduces the overall costs oftreatment of the patients. The cost savings is shared with the analysisprovider to incentivize the analysis provider to continue to developalgorithms and provide the remote analysis server.

In the system and method shown in the drawing Figures, a patient orother type of person uploads ECG data to the cloud for analysis by theremote analysis server 18 can elect to have the ECG data de-identifiedsuch that the ECG data can become part of a larger database of ECGinformation from patients that can be used for research purposes. Asdiscussed previously, the ECG data acquired by the acquisition device 10is typically uploaded to the cloud 12 and downloaded by the remoteanalysis server 18 for analysis and detection of arrhythmias. Ifarrhythmias are detected, the patient informational and ECG data isrelayed to healthcare providers such that the healthcare provider cancontact the patient to schedule additional testing and possibly apatient visit.

In the embodiment described in which the health website 28 is part of alarge institution, such as the Mayo Clinic, Cleveland Clinic or otherlarge healthcare provider, the large institution may be uploading alarge number of ECGs on a daily basis. If each ECG undergoes ade-identification process, the ECG data could be stored and analyzed forresearch purposes. In the case of a large healthcare institution, thepatient identification information can be encrypted such that only whenthe encryption key is present would the patient's identificationinformation be available. In this manner, the ECG data from a largenumber of patients can be analyzed for research purposes while thepatient information can be retrieved utilizing the encryption key.

In embodiments in which this information is de-identified, a copy of theECG records could be provided to a database at the remote analysisserver 18 without any patient information. This information could thenbe accessed by other healthcare providers, research institutions orother interested parties without the fear of any patient identification.

As the healthcare provider continues to treat the patient, thede-identified ECG data could be linked with de-identified EMR data,which includes treatment information and outcome data. This additionalinformation would have value and could be sold to drug companies andresearchers. In each case, both the ECG data and EMR data would bede-identified to prevent any patient information from being shared withthe entities accessing the data.

This written description uses examples to disclose the invention,including the best mode, and also to enable any person skilled in theart to make and use the invention. The patentable scope of the inventionis defined by the claims, and may include other examples that occur tothose skilled in the art. Such other examples are intended to be withinthe scope of the claims if they have structural elements that do notdiffer from the literal language of the claims, or if they includeequivalent structural elements with insubstantial differences from theliteral languages of the claims.

We claim:
 1. A method for analyzing ECG data obtained from patients, themethod comprising: obtaining ECG data and patient identificationinformation from the patient at a location; transmitting the obtainedECG data to an analysis server operated by an analysis provider andlocated remote from the location; analyzing the obtained ECG data toidentify abnormalities in the obtained ECG data; and referring thepatient identification information, ECG data and identifiedabnormalities to a healthcare provider.
 2. The method of claim 1 furthercomprising the step of providing a referral fee to the analysis providerfrom the healthcare provider.
 3. The method of claim 1 wherein the ECGdata and the patient identification information are obtained by anacquisition device and transmitted to the analysis server over theinternet.
 4. The method of claim 1 wherein the abnormality isarrhythmia.
 5. The method of claim 1 wherein the patient identificationinformation includes healthcare provider information for the patient. 6.The method of claim 1 further comprising the steps of: providing awebsite for the healthcare provider; and creating an ECG module withinthe website to obtain the ECG data from the patient.
 7. The method ofclaim 3 wherein the acquisition device is provided independent of theanalysis provider.
 8. The method of claim 1 further comprising the stepsof: obtaining a review quality selection from the patient; obtaining aresponse time selection from the patient; and analyzing the obtained ECGdata based on the obtained quality selection and response timeselection.
 9. The method of claim 8 further comprising the step ofproviding a cost of service to the patient based on the review qualityselection and the response time selection.
 10. The method of claim 8wherein one of the review quality selections included humanover-reading.
 11. The method of claim 8 further comprising the step ofobtaining a analysis type selection from the patient.
 12. The method ofclaim 1 further comprising the step of informing the patient upon afailure to detect an abnormality in the ECC data.
 13. The method ofclaim 3 further comprising the step of transmitting identificationinformation for the acquisition device with the ECG data, wherein theidentification information indicates a type of the acquisition device.14. The method of claim 13 wherein the analysis server includes aplurality of stored processing algorithm, wherein one of the storedprocessing algorithms is selected based on the type of acquisitiondevice.
 15. The method of claim 3 further comprising the step oftransmitting acquisition parameters of the acquisition device with theECG data.
 16. The method of claim 15 wherein the analysis serverincludes a plurality of stored processing algorithm, wherein one of thestored processing algorithms is selected based on the acquisitionparameters.
 17. A method for improving healthcare for patients served bya healthcare provider, the method comprising: Identifying a subset ofpatients within a prevention class; obtaining ECG data and patientidentification information from each of the patients in the subset;transmitting the obtained ECG data to a analysis server operated by ananalysis provider; analyzing the obtained ECG data to identifyabnormalities in the obtained ECG data; and referring the patientidentification information, ECG data and identified abnormalities to ahealthcare provider for treatment upon the identification of theabnormality; calculating a cost savings for the subset of patients; andallocating a portion of the cost savings to the analysis provider. 18.The method of claim 17 wherein the ECG data is obtained from the patientat an acquisition device at a location and the analysis server is at alocation remote from the location.
 19. The method of claim 18 whereinthe acquisition device is provided independent of the analysis provider.